The =lymph glands of the abdomen= consist of two main groups, parietal
and visceral. The =parietal glands= lie in the subperitoneal or
subcutaneous tissue; they receive the lymph vessels from the abdominal
and pelvic walls, from parts of the viscera, and from the proximal lymph
glands of the pelvic limbs. The =visceral glands= lie on the walls of
the viscera or in the peritoneal folds which connect the organs with the
wall or with adjacent viscera. They receive all or most of the lymph
vessels from the organs with which they are connected.
The =parietal glands= comprise the following:
1. The =lumbar lymph glands= (Lg. lumbales) lie along the course of the
abdominal aorta and posterior vena cava (Fig. 450). Some are placed
along the lower surface and sides of the vessels, others above. A few
small glands may be found above the sublumbar muscles. The small nodes
which are situated at the hilus of the kidneys are often termed the
renal lymph glands. They receive afferent vessels from the lumbar wall
of the abdomen and the paired viscera (kidneys, adrenals, genital
organs), also the inguinal vessels and the efferents of the iliac
glands. Their efferents go to the thoracic duct, constituting the lumbar
trunks of origin of that vessel.
2. The =internal iliac lymph glands= (Lg. iliacæ internæ) are grouped
about the terminal part of the aorta and the origins of the iliac
arteries (Fig. 450). Their afferent vessels come chiefly from the
pelvis, pelvic viscera, and tail, and they receive efferent vessels of
the external iliac and deep inguinal glands.
3. The =external iliac lymph glands= (Lg. iliacæ externæ) form a group
on either side on the iliac fascia at the bifurcation of the circumflex
iliac artery (Fig. 450). Their afferent vessels come from the flank and
abdominal floor, the outer surface of the thigh, and the precrural
glands. The efferent vessels go to the lumbar and internal iliac glands.
4. The =sacral lymph glands= (Lg. sacrales) are small nodes situated
along the borders of the sacrum and on its pelvic surface. They receive
afferents from the roof of the pelvis and from the tail, and their
efferent vessels pass to the internal iliac glands.
5. The =superficial inguinal lymph glands= (Lg. inguinales
superficiales) lie on the abdominal tunic in front of the external
inguinal ring (Fig. 457). They form an elongated group along the course
of the subcutaneous abdominal artery, on either side of the penis in the
male, above the mammary glands in the female; in the latter they are
often termed =mammary=. Their afferents come from the inner surface of
the thigh, the abdominal floor, the sheath and scrotum in the male, and
the mammary glands in the female. The efferent vessels ascend through
the inguinal canal and go to the deep inguinal and lumbar glands.
6. The =ischiatic lymph gland= (Lg. ischiadica) is a small node which
may be found at the lesser sciatic notch. It receives lymph from the
adjacent parts and from the popliteal glands, and sends efferents to the
sacral and internal iliac glands.
The =visceral glands= include the following:
1. The =gastric lymph glands= (Lg. gastricæ) are situated along the
course of the gastric arteries. Several occur along the attachment of
the gastro-phrenic ligament. A group lies at the lesser curvature a
short distance below the cardia. There is another small group on the
visceral surface where the posterior gastric artery divides into its
primary branches. Two or three small nodes are usually found on the
ventral aspect of the pylorus. Other small glands are scattered along
the course of the gastro-epiploic and short gastric arteries in the
great and gastro-splenic omenta. The efferent vessels pass largely to
the cœliac radicle of the thoracic duct, but along the left part of the
great curvature they go to the splenic glands.
2. The =hepatic lymph glands= (Lg. hepaticæ) lie along the portal vein
and hepatic artery and in the lesser omentum. Their efferent vessels go
to the cœliac radicle of the cisterna chyli.
Many of the lymph vessels from the parietal surface of the liver pass
in the falciform and lateral ligaments to the diaphragm and anastomose
with its lymphatics. Some pass through the diaphragm with the vena
cava and go to the mediastinal glands.
The =pancreatic lymph vessels= follow the course of the blood-vessels
which supply the gland; most of them go to the splenic and hepatic
glands.
3. The =splenic lymph glands= (Lg. lienales) lie along the course of the
splenic blood-vessels. Their afferent vessels come from the subscapular
network of the spleen, from the greater curvature of the stomach, and
from the left part of the pancreas. The efferents pass to the cœliac
radicle of the thoracic duct.
4. The =mesenteric lymph glands= (Lg. mesentericæ) are situated in the
great mesentery near its root. They are numerous and hence lie close
together. They receive a very large number of afferent vessels (400 to
500) from the small intestine. They have several considerable efferents
which concur in the formation of the intestinal radicles of the cisterna
chyli.
The lymph vessels of the intestine form three sets of capillary
plexuses, viz., in the subserosa, submucosa, and mucosa. The lymph
follicles, solitary and aggregate, lie in the zone of the plexus of
the mucosa. The collecting vessels arise from the subserous plexus.
5. The =lymph glands of the cæcum= are numerous and are distributed
along the course of the cæcal blood-vessels. Their efferents enter into
the formation of an intestinal radicle of the cisterna chyli.
6. The =lymph glands of the great colon= are extremely numerous and are
placed close together along the colic blood-vessels. Their efferent
vessels are large and numerous. They converge to two large trunks which
concur with those of the cæcum and small intestine to form an intestinal
radicle of the cisterna chyli.
The intestinal radicles of the cisterna chyli are formed by the
confluence of efferents from the intestinal lymph glands. The anterior
trunk lies on the left side of the anterior mesenteric artery, passes
between that vessel and the cœliac artery, turns sharply backward
across the right renal vessels and opens into the cisterna. It is
formed by the union of the cœliac trunk with efferents from the glands
of the small intestine, cæcum and colon. It is about four inches (ca.
10 cm.) in length and is ampullate. The posterior trunk receives
vessels from the small intestine and small colon. It usually opens
into a trunk formed by the union of the right and left lumbar ducts.
It is usually ampullate at its termination (Franck). The arrangement
of these collecting trunks is, however, very variable.
7. The =lymph glands of the small colon= are situated in part on the
wall of the bowel along the attachment of the mesentery, in part between
the layers of the latter along the course of the blood-vessels. The
efferent vessels go to the lumbar glands and to the posterior intestinal
radicle of the thoracic duct.
The =lymph vessels of the rectum= pass chiefly to the lumbar and
internal iliac glands.
8. The =anal lymph glands= (Lg. anales) form a small group on either
side of the sphincter ani externus (Figs. 451, 453). They receive
afferents from the anus, perineum, and tail. Their efferents go to the
internal iliac glands.